HORMONE REPLACEMENT IN MENOPAUSAL WOMEN

工作概要：截至1997年7月1日，106名妇女参加了 BLSA围绝经期研究，并已完成其第一次住院治疗 评估和至少一次季度门诊GCRC访视。 共 完成了631次门诊就诊，每名妇女就诊1次至16次不等。 共有13名妇女完成了27次住院GCRC访问， 夜间频繁采血。 在这些妇女中，有两人被列为 围绝经期（基于卵泡刺激素的测量， 但他们在最后一次月经的两年内。分析 已经完成了从10个人中获得的夜间GH分泌数据， 绝经前妇女在一次月经的早期和晚期 周期 GH分泌在两个阶段之间没有差异， 月经周期 对纵向数据的初步分析如下： 当至少6名女性的血浆FSH水平高时进行。 另外两 绝经前妇女同意在未来三个月内接受研究 来完成15名女性的研究队列。 我们还分析了纵向骨矿物质密度（BMD）测量 在腰椎和臀部。 27名女性仍处于绝经前（PRE）， 随访> 1年（平均2.5年），平均年龄为48.7 ± 0.3岁。 他们与21名被归类为围绝经期（PERI）的妇女进行了比较， 至少一次访视> 0.3年前（平均0.84年）和至少一次访视>1 1.90岁（平均1.90岁）后，他们最初的高FSH值。随访 平均年龄2.7岁，平均年龄50.3 ± 0.6岁。 有一个显着增加骨密度在脊柱，而PERI组有一个 大幅下降。 两组的BMD值也 显著性差异 PRE组和PERI组都输了 股骨颈和转子区域的骨。 没有 在任何髋关节部位，PRE和PERI之间存在显著差异。这些数据 证实了预期的加速椎骨骨丢失， 围绝经期过渡，而类似的损失，髋关节骨密度在前 和围绝经期妇女似乎没有区别，这表明， 髋部骨折的风险可能不会开始增加，直到绝经后 期 测量骨生物标志物的试验已经完成， 到1997年1月2日为止的访问。数据分析正在进行中，以确定是否连续 这些变化与骨密度的变化相关。 身体成分通过DEXA和人体测量学测量。 到目前为止， 完整的身体组成数据可用于21名妇女谁仍然 绝经前和24名被归类为围绝经期，如定义 以上 未测量任何身体组成参数（体重、身体 体重指数、腰围、腰臀比、DEXA总脂肪量 扫描，或%脂肪）在基线时PRE和PERI组之间通过ANOVA差异。 PERI女性在估计值方面表现出显著的纵向增长 与PRE组相比， 以及脂肪分布指数（腰围）的差异 和WHR，p<0.05），和血清瘦素水平（p<0.03），但体重 或体重指数。 这些数据表明身体成分的变化 可能发生在绝经过渡期早期。

Summary of work: As of July 1, 1997, 106 women have been enrolled in the BLSA Perimenopausal Study and have completed their first inpatient assessments and at least one quarterly outpatient GCRC visit. A total of 631 outpatient visits have been completed, ranging from 1 to 16 per woman. A total of 27 inpatient GCRC visits have been completed by 13 women for overnight frequent blood sampling. Of these women, two are classified as perimenopausal (based on measurement of the follicle stimulating hormone, FSH) but they are within two years of their last menses. Analyses of nocturnal GH secretion has been completed for data obtained from ten of the premenopausal women during both early and late phases of one menstrual cycle. There was no difference in GH secretion in between phases of the menstrual cycle. A preliminary analysis of the longitudinal data will be performed when plasma FSH levels are high in at least 6 women. Two more premenopausal women have agreed to be studied within the next three months to complete the study cohort of 15 women. We have also analyzed longitudinal bone mineral density (BMD) measurements at the lumbar spine and hip. The 27 women who remain premenopausal (PRE), were followed > 1 yr (mean 2.5 yrs), and had a mean age of 48.7+/-0.3 yrs. They were compared to 21 women classified as perimenopausal (PERI),with at least one visit > 0.3 yrs before (mean 0.84 yrs) and at least one visit >1 yr after (mean 1.90 yrs) their initial high FSH values. They were followed an average of 2.7 yrs, and had a mean age of 50.3+-0.6 yrs. The PRE group had a significant increase in BMD in the spine while the PERI group had a significant decrease. The BMD values of the two groups were also significantly different . Both the PRE and the PERI groups were losing bone at the femoral neck and trochanteric region. There was no significant difference between PRE and PERI at any hip site.These data confirm the expected accelerated vertebral bone loss during the perimenopausal transition, whereas the similar losses of hip BMD in pre- and perimenopausal women appear not to be distinguishable, suggesting that hip fracture risk may not start to increase until the post-menopausal period. The assays to measure bone biomarkers have been completed for visits up to 2/1/97. Data analyses are underway to determine if serial changes correlate with changes in bone density. Body composition is measured by DEXA and anthropometrics. To date, complete body composition data are available for 21 women who remain premenopausal and 24 who are classified as perimenopausal, as defined above. None of the parameters of body composition measured (weight, body mass index, waist circumference, waist-hip ratio, total fat mass by DEXA scan, or % fat) differed by ANOVA between PRE and PERI groups at baseline. The PERI women exhibit significant longitudinal increases in the estimates of fatness (total fat and % fat by DEXA) compared with the PRE group as well as differences in indices of fat distribution (waist circumference and WHR, p<0.05), and in serum leptin levels (p<0.03), but not in weight or body mass index. These data suggest that changes in body composition may occur early in the menopausal transition.